Friday, June 30, 2023

AMA Releases New Category III Codes: Numerous Codes for Digital Pathology

SHORT READ:  July 2023, AMA releases even more digital pathology codes, expanding from those released January 2023.  


In 2022, effective 1/1/2023, AMA created about a dozen Category III codes for digital pathology.  CMS has said "nope" to paying for them in the hospital outpatient setting, where a lot of biopsies originate.  See here.

On June 30, 2023, AMA released all the new Category III codes effective January 1, 2024, and it again includes a lengthy roster of digital pathology codes.  There are also revisions to the existing January 2023 codes.

At a glance, the codes run from 0827T to 0856T or about 30 codes. 

Read and review them all here:

A screen shot with a peek at the new text is here, click to enlarge.

I believe CMS will discuss the codes from January 2023 in the imminent summer rulemaking (OPPS and/or PFS) and will post valuations for these late-breaking newest codes in the November 2023 final OPPS rulemaking.